Lecture 32 Therapy and Treatment Psychotherapy 1 I

Lecture 32: Therapy and Treatment: Psychotherapy ‹#› 1

I. THERAPY AND TREATMENT A. Introduction § Two forms of therapy are administered by people with very different training § Biological Treatments: Drugs or direct intervention in brain function. § Psychiatrists or other physicians (MDs) administer drugs or direct interventions to patients in hospital settings or as outpatients § Psychotherapy: An array of psychological approaches including psychoanalytic, cognitive, behavioral, humanistic, and other approaches § Psychologists: Ph. D. Ed. D. Psy. D. § Social Workers: MSW § Marriage and Family Therapy: MFT

II. PSYCHOTHERAPY A. Nature and Assumptions § Psychotherapeutic techniques are based theoretically on assumptions about human nature § Each psychotherapeutic approach has… § Image of the patient: What is the status of the person presenting a problem? § Image of therapist: What role does the mental healthy professional adopt? § Process of Therapy: What is the essential therapeutic process? § Techniques: What strategies are used to promote change?

II. PSYCHOTHERAPY B. Psychoanalytic § Image of patient: As a patient § Image of therapist: As an expert § Process of Therapy: Insight. Understand then rid patient of unconscious conflicts and defenses constructed to defend against conflict. § Therapeutic Techniques: Identify the unconscious conflict. § § B 1. Free associations: A method of uncovering unconscious conflicts by saying freely whatever comes to mind. Augments Dream Analysis and Projective tests. B. 2 Transference: A critical step in which a patient transfers emotions and reactions (conflicts) onto therapists.

II. PSYCHOTHERAPY C. Behavioral Therapy § Image of patient: As a patient § Image of therapist: As an expert § Process of Therapy: Learn new behaviors through mechanisms of learning like modeling reinforcement, punishment, extinction, etc. § Therapeutic Techniques: Identifying and changing responses to stimuli. § C 1. Systematic Desensitization: A step by step process of desensitizing a patient to a feared object or experience. Associate the stimulus to an incompatible response.

II. PSYCHOTHERAPY C. Behavioral Therapy § Test anxiety reduced by imagining taking a test while relaxed. The process is gradual. § Tests fear § Tests relaxation § C 2. Aversive Conditioning: Punishment is substituted for the reinforcement that supports a bad habit. § Nail Biting is behavior which escape anxiety. § Rubber band snapped to punish nail biting. § C 3. Exposure Treatment (Flooding) : Confront the patient with anxiety disorders (Panic attacks, phobias) with the source of their anxiety until the anxiety subsides (Extinction).

II. PSYCHOTHERAPY C. Behavioral Therapy § Phobias of Snakes can be treated by placing patients in room full of snakes. § Panic Attacks results in agoraphobia which is treated by sending patients them out to confront their fears § C 4. Behavioral Records: Helps to identify the environmental contingencies which give rise and support abnormal behavior. § Behavioral records used in order to get a sense of the timing and conditions of the unwanted behavior. § C 5. Skill Training: Provides practice in behavior that are necessary for achieving a goal. § Provide social skills to a shy persons.

II. PSYCHOTHERAPY D. Cognitive Therapy § Image of patient: As a client § Image of therapist: As a facilitator § Process of Therapy: Rid clients of their irrational thoughts. § Therapeutic Techniques: Strategies for challenging and changing non-adaptive and irrational thoughts, beliefs, and attitudes. § D 1. Rational-Emotive Therapy: Rational arguments are used to directly challenge a clients unrealistic beliefs or expectations § Over-generalization: One bad outcome person evaluates himself as incompetent

II. PSYCHOTHERAPY D. Cognitive Therapy § D 2. Beck’s Cognitive Therapy: Less direct challenges of irrational thoughts. Test beliefs to discover limits of truth. § Treating Catastrophizing: Limiting the tendency to make normal upsets and problems into catastrophes. § Treating Depression: Treatment aligned to behavior therapy. Direct the patient to have more rational thoughts about his or her self by pointing out contradictions

II. PSYCHOTHERAPY E. Humanistic Therapy § Image of patient: As a client § Image of therapist: As a facilitator § Process of Therapy: Provide the safe environment for a patient to help themselves and work out their own solutions to problems. § Therapeutic Techniques: Processes to create safe environments: § E 1. Client-centered or non-directive therapy: Rodgers: Listen to client needs in an accepting warm, and nonjudgmental way. § Build Self-esteem through the creation of an environment of genuineness, acceptance, and empathy.

II. PSYCHOTHERAPY F. Other Therapies § Family Therapy: Social context of the family may be an interesting perspective to examine abnormal behavior. § Most family members unaware of their influence. § Genogram: Examination of patterns of behavior across generations: § Family Systems theory: People’s behavior in a family is interconnected bees like a dance. § Group Therapy: People with the same or different problems find solutions to their problems together.

II. PSYCHOTHERAPY G. Therapeutic Process § 1. Characteristics of the patient § Want to change and has support from family § Patient/client is a a “problem-solver” not avoider § 2. Characteristics of therapist § Empathy, acceptance, genuineness § Make clients feel respected accepted and understood § 3. Therapeutic Alliance § Therapeutic Alliance: The bond of confidence and mutual understanding established between therapist and client which allows them to work together to solve the client’s problem. § Similar backgrounds may be important § Role of culture: Understand local significance of behavior.